The results of surgery for mediastinal parathyroid tumors: a comparative study of 63 patients

Abstract

Conventional cervicotomic parathyroidectomy may achieve satisfactory results, especially for upper mediastinal glands. Sternotomic approaches are effective, but should be limited because of invasiveness and increased morbidity. In case of deep and lower hyperfunctioning mediastinal parathyroids, video-assisted approaches represent a less invasive, effective, and safe alternative and might be the technique of choice.

Intrathymic Parathyroid Adenoma

“…Those complications include pleural effusions, sternal wound infection, mediastinitis and recurrent laryngeal nerve palsies (18.7%) [1].…”

“…Thoracoscopy has been suggested as the technique of choice for ectopic glands located to the middle and lower mediastinal regions but some limitations have been reported in case of immediately retrosternal parathyroids in the upper part of the anterior mediastinum, with an increased risk of convertion [1].…”

“…Parathyroid glands may also have an ectopic position, especially at mediastinal site, up to 25% of cases [1]. The hyper-functioning adenoma is ectopically placed in the mediastinum in 1% -2% of cases [2].…”

Thoracic Exploration for Mediastinal Parathyroids requires a Multidisciplinary Approach

“…1 The majority of parathyroid glands are located in the cervical region, however, they can be located in ectopic locations in up to 25% of cases, including the mediastinum. 2 The majority of mediastinal parathyroid glands can be excised via a cervical incision, with a minority requiring a thoracic approach. Patients requiring thoracic approaches for excision of ectopic parathyroid glands represent a unique challenge with respect to preoperative and intraoperative localization of the ectopic mediastinal gland.…”

Surgical endocrinology—update 2010

“…More extended exporation by sternotomy is effective, but should be limited because of invasiveness and increased morbidity. In case of deep and lower, well localised hyperfunctioning mediastinal parathyroids, videoassisted approaches represent a less-invasive, effective and safe alternative to sternotomy or thoracotomy and might be the technique of choice ( [13] Langenbecks Arch Surg, this issue)…”